Individual
MISS ANA PATRISIA OLVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
5609 DONNYBROOK AVE, TYLER, TX 75703-6111
(903) 561-2808
Mailing address
1002B FAIRWAY DR, LONGVIEW, TX 75604-3858
(903) 445-2211
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
210111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1100190-02
—
TX
Enumeration date
01/17/2008
Last updated
01/27/2009
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